The Executive Suite: Remote monitoring a valuable tool for reducing heart failure readmissions and hospitalization

Nearly 5 million Americans are living with heart failure with an estimated 550,000 new cases diagnosed each year. Heart failure is responsible for 11 million physician visits each year, more hospitalizations than all forms of cancer combined, and contributes to approximately 287,000 deaths each year.

Advances in remote monitoring are allowing for physician practices to further monitor heart failure patients on a regular basis, without the patients needing to leave their home. This real-time data provides seamless connectivity, improved clinical outcomes, and reductions of adverse events.

While remote monitoring has been in place for many years, it began to flourish in 2019-2020, when CMS finalized new reimbursement rules for remote patient monitoring, paving the way for reimbursement of heart failure remote management. Essentially, these new CPT codes provided for more incentives for physicians and care teams to spend within virtual patient care.

Even though the initial adoption of remote monitoring had been slow, the interest from physicians significantly took off since the recent pandemic as practices began to seek more efficient and innovative ways to manage high-risk patients while they are away from the clinic.

This shift in mindset toward close daily monitoring, particularly of heart failure patients, helps visualize dangerous trends and prevents disruptions of care plans. Remote monitoring allows practices to better allocate limited resources, such as staff time. By doing so, providers are able to better focus their time on higher acuity matters.

“It’s important to be able to monitor heart failure in patients so we know what’s going on in real-time, which will allow us to reduce hospitalizations and costly readmissions,” said Marc Silver, MD, an international leader in the research and treatment of heart failure and founding member of the Heart Failure Society of America. “This is the only way we’ll be able to deliver effective treatment that helps slow the progression of heart disease and leads to better outcomes for patients, and providers,”

Real-time remote monitoring delivers more accurate data and immediate connectivity to healthcare providers. Prior to remote monitoring, care teams relied on patient diaries to track historical information. While this type of data was useful for showing historical trends, it was often working backwards and did not provide timely and actionable information for care teams to help patients remain in stable situations.

With remote monitoring, care teams are able to see a “daily diary” of their patients and make decisions that improve care and prevent adverse events in real time. Heart failure patients that are monitored remotely typically see improved quality of life and reduced hospitalizations.

“Heart failure is an ongoing epidemic. Remote patient monitoring focuses on preventative care. It allows us to identify any missed opportunities with the care plan,” said Silver.

As practices and hospitals are measured on quality metrics, remote monitoring provides a valuable resource within the heart failure space. For the majority of organizations, studies have shown that remote monitoring can deliver a sizeable improvement in both quality and cost benefit. In addition, remote data is beneficial in providing health professionals with large-scale insight on how to better care for a multitude of patients.

“We have incorporated remote patient monitoring as a key management tool for reducing hospitalizations and readmissions. Remote monitoring allows us to deliver optimal therapies for our patients,” said Rachel Robinson, director of quality and risk management for MercyOne Iowa Heart Center.

“Recently we enrolled 450 of our patients in a 30-60-90 day study to evaluate the impact remote monitoring platforms have on reducing hospitalizations in our current standard of care for heart failure,” said Robinson. “Preliminary study results show great improvements in readmission and hospitalization reductions, as well as increased use of optimized and guideline-directed therapies for treatment.”

As physician practices continue to become more receptive of remote monitoring tools, heart failure patients will as well. With remote monitoring, patients are able to remain very engaged, stay connected with their providers, and have a personal opportunity to share data from their perspective.

“It’s nice to have someone else interested in what you’re doing,” said William Wheeler, an eighty-one-year-old heart failure patient from Freemont, IA, who has received care from the Iowa Heart Center. “They can tell by looking if things are out of range. I have had a couple of times where my numbers didn’t look good. They reported to the doctor, and the doctor called right away and made some changes. That wouldn’t have happened without the remote monitoring from my physician."

In addition to increased patient engagement, remote monitoring is shown to improve motivation and education, as well as adherence to guidelines. Having heart failure patients more involved in their care is a key element of improving outcomes.

While there are numerous benefits to remote monitoring, challenges still remain in achieving widespread industry adoption. Practices that are seen as early adopters and innovative thought leaders in the treatment of heart failure, are typically more willing to adopt remote monitoring care. Organizations like Iowa Heart Center have adopted and are scaling remote patient monitoring for heart failure and other high-risk patients.

"Getting providers to change the way they care for patients is hard. We need a new standard of care for remote patient monitoring that’s focused on evidence-based practice to drive adoptions" said Dr. Silver